H66.9
DESCRIPTION
Inflammation of the middle ear that may be complicated by perforation and a purulent ear discharge, which usually resolves spontaneously within 14 days.
DIAGNOSTIC CRITERIA
- Frequently preceded by a viral upper respiratory tract infection.
- Fever and earache (not due to referred pain).
- Acute purulent otorrhoea may develop with associated relief of otalgia.
OR at least one of the following:
- Distinct fullness or bulging of the tympanic membrane.
- Marked redness of the tympanic membrane.
- Needs to be distinguished from otitis media with effusion.
| Signs and symptoms |
Otitis media with Effusion |
Acute Otitis Media |
|---|---|---|
| Impaired hearing | Mild-to-moderate | Mild-to-moderate |
| Pain (otalgia) | No | Moderate-to-severe |
| Tenderness | No | No |
|
Purulent drainage (otorrhea) |
No |
Only after perforation of tympanic membrane |
| Bacterial infection | No | Yes |
|
Systemic symptoms (ie, fever, malaise) |
No | Yes |
GENERAL AND SUPPORTIVE MEASURES
- Avoid getting the inside of the ear wet.
MEDICINE TREATMENT
- Amoxicillin, oral, 45 mg/kg/dose 12 hourly for 5–10 days.
Note: For poor response to amoxicillin therapy, or in patients who have received amoxicillin in the last 30 days:
- Amoxicillin-clavulanic acid, oral, 15-25mg/kg/dose of amoxicillin component, 8 hourly for 5-10 days.
For pain:
- Refer to Chapter: Pain Control, Management of Pain .